Average Medicaid Prescription Medications Payments
Typical Medicaid Prescription Medications reimbursement across 5,304 cities
Avg. Medicaid Paid
$28.35
Price Range
$0.00 β $2,704
Total Claims
61.1M
Cities
5304
Typical Payment Range
Typical Medicaid Prescription Medications payments fall between $0.68 and $14.54 per claim (median: $2.87). The top 10% of payments exceed $78.92.
Based on per-provider averages across all Medicaid claims in this category.
About This Procedure
Prescription drug costs and pharmacy services covered under Medicaid. Includes brand-name and generic medications across all therapeutic categories.
Why do these costs look low?
These figures represent Medicaid reimbursement rates β the amounts that state Medicaid programs actually paid providers. Medicaid typically reimburses significantly less than private insurance or out-of-pocket prices. If you have private insurance or are paying cash, expect higher costs. See the cost components below for per-code averages.
Costs by City
| City | Avg. Paid | Min / Max | Claims | Providers |
|---|---|---|---|---|
| Pearl, MS | $0.30 | $0.00 β $0.43 | 64 | 2 |
| Brentwood, CA | $0.00 | $0.00 β $0.00 | 64 | 1 |
| Wesson, MS | $0.00 | $0.00 β $0.00 | 64 | 1 |
| Ketchum, ID | $2.76 | $2.76 β $2.76 | 65 | 1 |
| San Rafael, CA | $6.87 | $3.75 β $8.70 | 65 | 2 |
| Blaine, MN | $4.21 | $0.15 β $6.83 | 65 | 3 |
| Mchenry, IL | $82.13 | $82.13 β $82.13 | 65 | 1 |
| West Melbourne, FL | $6.96 | $6.96 β $6.96 | 65 | 1 |
| Huntingburg, IN | $12.92 | $0.00 β $19.53 | 65 | 2 |
| Roscoe, IL | $52.20 | $2.45 β $81.33 | 65 | 2 |
| Dahlonega, GA | $0.59 | $0.59 β $0.59 | 65 | 1 |
| Nyc, NY | $0.99 | $0.27 β $1.94 | 65 | 2 |
| Wallace, NC | $48.02 | $48.02 β $48.02 | 65 | 1 |
| Riverbank, CA | $205.38 | $205.38 β $205.38 | 65 | 1 |
| Magna, UT | $19.66 | $12.00 β $21.96 | 65 | 2 |
| Jonesville, VA | $1.34 | $1.34 β $1.34 | 65 | 1 |
| Tunica Resorts, MS | $0.04 | $0.04 β $0.04 | 65 | 1 |
| Sidney, NE | $3.26 | $0.00 β $13.25 | 66 | 3 |
| Arroyo, PR | $0.00 | $0.00 β $0.00 | 66 | 1 |
| Uniontown, AL | $0.00 | $0.00 β $0.00 | 66 | 1 |
| Norwood, OH | $10.62 | $0.96 β $15.84 | 67 | 3 |
| Abbeville, SC | $11.26 | $0.00 β $55.73 | 67 | 3 |
| Sapulpa, OK | $3.73 | $3.73 β $3.73 | 67 | 1 |
| Villalba, PR | $0.06 | $0.06 β $0.06 | 67 | 1 |
| Gueydan, LA | $0.00 | $0.00 β $0.00 | 67 | 1 |
| Larchmont, NY | $0.35 | $0.35 β $0.35 | 67 | 1 |
| Tiptonville, TN | $1.00 | $1.00 β $1.00 | 67 | 1 |
| Tolleson, AZ | $1.66 | $1.66 β $1.66 | 67 | 1 |
| Middlebrook, VA | $0.40 | $0.40 β $0.40 | 67 | 1 |
| Atascadero, CA | $63.40 | $29.70 β $90.00 | 68 | 2 |
| Saint Augustine, FL | $0.05 | $0.05 β $0.05 | 68 | 1 |
| Chiloquin, OR | $0.00 | $0.00 β $0.00 | 68 | 1 |
| Taylorsville, NC | $8.90 | $0.01 β $21.59 | 68 | 2 |
| Providence, UT | $1.30 | $1.30 β $1.30 | 68 | 1 |
| Estacada, OR | $1,166 | $1,166 β $1,166 | 68 | 1 |
| Byram, MS | $0.70 | $0.30 β $0.82 | 68 | 2 |
| Osceola, WI | $0.03 | $0.03 β $0.03 | 68 | 1 |
| Lakewood, OH | $176.26 | $0.00 β $782.14 | 69 | 4 |
| Pinole, CA | $1,212 | $57.48 β $1,480 | 69 | 2 |
| Falkville, AL | $0.45 | $0.45 β $0.45 | 69 | 1 |
| Waltham, MA | $10.72 | $10.72 β $10.72 | 69 | 1 |
| Nottingham, MD | $1.13 | $1.12 β $1.14 | 69 | 2 |
| Van Horn, TX | $0.84 | $0.84 β $0.84 | 69 | 1 |
| Cataula, GA | $0.84 | $0.84 β $0.84 | 69 | 1 |
| Worrester, MA | $0.73 | $0.73 β $0.73 | 69 | 1 |
| Carthage, MO | $0.26 | $0.26 β $0.26 | 70 | 1 |
| Channahon, IL | $629.07 | $598.31 β $675.20 | 70 | 2 |
| Tuskegee, AL | $0.42 | $0.00 β $0.57 | 70 | 2 |
| Waukegan, IL | $12.21 | $3.48 β $24.86 | 71 | 2 |
| Gainesboro, TN | $38.32 | $38.32 β $38.32 | 71 | 1 |
Cost Components
National averages for each billing code in this procedure category. Sorted by claim volume.
| Code | Description | Avg. Paid | Claims | Providers |
|---|---|---|---|---|
| J1100 | Dexamethasone sodium phos | $3.37 | 17,408,335 | 19,920 |
| J1270 | Injection, doxercalciferol | $16.67 | 15,455,545 | 1,785 |
| J0696 | Ceftriaxone sodium injection | $4.52 | 8,442,343 | 9,869 |
| J1170 | Hydromorphone injection | $3.20 | 6,069,586 | 3,002 |
| J1200 | Diphenhydramine hcl injectio | $3.10 | 5,922,771 | 3,790 |
| J0690 | Cefazolin sodium injection | $5.07 | 4,950,109 | 2,942 |
| J1050 | Medroxyprogesterone acetate | $38.04 | 2,722,661 | 5,740 |
| J0131 | Inj, acetaminophen (nos) | $15.79 | 2,017,135 | 1,612 |
| J1030 | Methylprednisolone 40 mg inj | $5.08 | 1,577,497 | 4,461 |
| J0882 | Darbepoetin alfa, esrd use | $63.10 | 1,115,197 | 646 |
| J1040 | Methylprednisolone 80 mg inj | $6.39 | 1,102,119 | 2,895 |
| J0585 | Injection,onabotulinumtoxina | $534.00 | 949,108 | 1,450 |
| J0702 | Betamethasone acet&sod phosp | $9.01 | 907,372 | 2,580 |
| J0780 | Prochlorperazine injection | $4.11 | 869,130 | 1,089 |
| J0178 | Aflibercept injection | $802.42 | 747,781 | 1,182 |
| J0171 | Adrenalin epinephrine inject | $5.61 | 533,091 | 956 |
| J0897 | Denosumab injection | $708.53 | 175,698 | 394 |
| J1071 | Inj testosterone cypionate | $3.01 | 121,666 | 206 |
| J0636 | Inj calcitriol per 0.1 mcg | $2.19 | 94,974 | 28 |
| J0885 | Epoetin alfa, non-esrd | $82.64 | 88,458 | 179 |
| J1020 | Methylprednisolone 20 mg inj | $3.48 | 88,065 | 344 |
| J0881 | Darbepoetin alfa, non-esrd | $149.52 | 63,199 | 108 |
| J0878 | Daptomycin injection | $167.80 | 55,762 | 36 |
| J1245 | Dipyridamole injection | $5.21 | 54,912 | 138 |
| J0592 | Buprenorphine hydrochloride | $15.56 | 48,440 | 32 |
| J0153 | Adenosine inj 1mg | $18.75 | 46,321 | 143 |
| J0670 | Inj mepivacaine hcl/10 ml | $0.91 | 37,668 | 90 |
| J0129 | Abatacept injection | $1,614 | 34,397 | 89 |
| J0735 | Clonidine hydrochloride | $6.85 | 32,191 | 92 |
| J0610 | Calcium glucon (fresenius) | $9.34 | 31,253 | 88 |
| J0135 | Adalimumab injection | $738.85 | 28,382 | 35 |
| J1094 | Inj dexamethasone acetate | $2.39 | 27,586 | 144 |
| J0717 | Certolizumab pegol inj 1mg | $2,072 | 22,279 | 41 |
| J0697 | Sterile cefuroxime injection | $0.94 | 18,132 | 47 |
| J0256 | Alpha 1 proteinase inhibitor | $2,389 | 16,156 | 1 |
| J1250 | Inj dobutamine hcl/250 mg | $6.92 | 14,579 | 60 |
| J0588 | Incobotulinumtoxin a | $295.98 | 10,950 | 18 |
| J1325 | Epoprostenol injection | $636.33 | 9,713 | 5 |
| J1240 | Dimenhydrinate injection | $0.02 | 8,738 | 12 |
| J1000 | Depo-estradiol cypionate inj | $11.84 | 1,738 | 11 |
| J1230 | Methadone injection | $4.00 | 1,439 | 2 |
| J1212 | Dimethyl sulfoxide 50% 50 ml | $175.32 | 1,145 | 5 |
| J1265 | Dopamine injection | $2.67 | 840 | 1 |
| J0132 | Acetylcysteine injection | $0.11 | 814 | 6 |
| J0834 | Inj., cosyntropin, 0.25 mg | $60.82 | 696 | 6 |
| J1120 | Acetazolamid sodium injectio | $8.30 | 446 | 4 |
| J0713 | Inj ceftazidime per 500 mg | $8.01 | 398 | 5 |
| J0698 | Cefotaxime sodium injection | $0.61 | 371 | 9 |
| J0775 | Collagenase, clost hist inj | $9,463 | 323 | 1 |
| J0207 | Amifostine | $23.74 | 42 | β |
| J0120 | Tetracyclin injection | β | β | β |
| J0133 | Acyclovir injection | β | β | β |
| J0202 | Injection, alemtuzumab | β | β | β |
| J0795 | Corticorelin ovine triflutal | β | β | β |
| J1160 | Digoxin injection | β | β | β |
| J1205 | Chlorothiazide sodium inj | β | β | β |
| J1260 | Dolasetron mesylate | β | β | β |
| J1290 | Ecallantide injection | β | β | β |
| J1300 | Eculizumab injection | β | β | β |
| J1301 | Injection, edaravone, 1 mg | β | β | β |
| J1303 | Inj., ravulizumab-cwvz 10 mg | β | β | β |
| J1305 | Inj, evinacumab-dgnb, 5mg | β | β | β |
| J1320 | Amitriptyline injection | β | β | β |
| J1322 | Elosulfase alfa, injection | β | β | β |
| J1327 | Eptifibatide injection | β | β | β |
These averages group common billing codes used when providers bill Medicaid for this procedure. Individual costs will vary.